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Disinhibited social engagement in postinstitutionalized children: Differentiating normal from atypical behavior

  • Jamie M. Lawler (a1), Camelia E. Hostinar (a1), Shanna B. Mliner (a1) and Megan R. Gunnar (a1)

The most commonly reported socially aberrant behavior in postinstitutionalized (PI) children is disinhibited social engagement (DSE; also known as indiscriminate friendliness). There is no gold standard for measurement of this phenomenon nor agreement on how to differentiate it from normative behavior. We adopted a developmental psychopathology approach (Cicchetti, 1984) to study this phenomenon by comparing it to normative social development and by studying its patterns over time in 50 newly adopted PI children (16–36 months at adoption) compared with 41 children adopted early from foster care overseas and 47 nonadopted (NA) controls. Using coded behavioral observations of the child's interaction with an unfamiliar adult, atypical behaviors were differentiated from normative behaviors. Principal components analysis identified two dimensions of social disinhibition. The nonphysical social dimension (e.g., initiations, proximity) showed wide variation in NA children and is therefore considered a typical form of sociability. Displays of physical contact and intimacy were rare in NA children, suggesting that they represent an atypical pattern of behavior. Both adopted groups demonstrated more physical DSE behavior than NA children. There were no group differences on the nonphysical factor, and it increased over time in all groups. Implications for understanding the etiology of DSE and future directions are discussed.

Corresponding author
Address correspondence and reprint requests to: Jamie M. Lawler, Institute of Child Development, University of Minnesota, 51 East River Road, Minneapolis, MN 55455; E-mail:
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American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Brannick, M. T. (1995). Critical comments on applying covariance structure modeling. Journal of Organizational Behavior, 16, 201213.
Bruce, J., Tarullo, A. R., & Gunnar, M. R. (2009). Disinhibited social behavior among internationally adopted children. Development and Psychopathology, 21, 157171.
Cicchetti, D. (1984). The emergence of developmental psychopathology. Child Development, 55, 17.
Chisholm, K. (1998). A three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development, 69, 10921106.
Chisholm, K., Carter, M. C., Ames, E. W., & Morison, S. J. (1995). Attachment security and indiscriminately friendly behavior in children adopted from Romanian orphanages. Development and Psychopathology, 7, 283294.
English and Romanian Adoptees (ERA) Study Team. (2010). II. Methods and measures used for follow-up at 15 years of the English and Romanian Adoptee (ERA) study. Monographs of the Society for Research in Child Development, 75, 2147.
Fisher, L., Ames, E. W., Chisholm, K., & Savoie, L. (1997). Problems reported by parents of Romanian orphans adopted to British Columbia. International Journal of Behavioral Development, 20, 6782.
Gleason, M. M., Fox, N. A., Drury, S., Smyke, A., Egger, H. L., Nelson, C. A., et al. (2011). Validity of evidence-derived criteria for reactive attachment disorder: Indiscriminately social/disinhibited and emotionally withdrawn/inhibited types. Journal of the American Academy of Child & Adolescent Psychiatry, 50, 216231.
Gorsuch, R. L. (1983). Factor analysis (2nd ed). Mahwah, NJ: Erlbaum.
Gunnar, M. R. (2001). Effects of early deprivation: Findings from orphanage-reared infants and children. In Nelson, C. A. & Luciana, M. (Eds.), Handbook of developmental cognitive neuroscience (pp. 617629). Cambridge, MA: MIT Press.
Gunnar, M. R., Bruce, J., & Grotevant, H. D. (2000). International adoption of institutionally reared children: Research and policy. Development and Psychopathology, 12, 677693.
Gunnar, M. R., & van Dulmen, M. H. (2007). Behavior problems in postinstitutionalized internationally adopted children. Development and Psychopathology, 19, 129148.
Hodges, J., & Tizard, B. (1989). Social and family relationships of ex-institutional adolescents. Journal of Child Psychology and Psychiatry, 30, 7797.
Kreppner, J., Kumsta, R., Rutter, M., Beckett, C., Castle, J., Stevens, S., et al. (2010). IV. Developmental course of deprivation-specific psychological patterns: Early manifestations, persistence to age 15, and clinical features. Monographs of the Society for Research in Child Development, 75, 79101.
Lyons-Ruth, K., Bureau, J. F., Riley, C. D., & Atlas-Corbett, A. F. (2009). Socially indiscriminate attachment behavior in the strange situation: Convergent and discriminant validity in relation to caregiving risk, later behavior problems, and attachment insecurity. Development and Psychopathology, 21, 355367.
Mulaik, S. A. (2010). Foundations of factor analysis (2nd ed.). Boca Raton, FL: Chapman & Hall/CRC.
Mullen, E. M. (1995). Mullen Scales of Early Learning. Circle Pines, MN: American Guidance Service.
O'Connor, T. G., Bredenkamp, D., Rutter, M., & the ERA Study Team. (1999). Attachment disturbances and disorders in children exposed to early severe deprivation. Infant Mental Health Journal, 20, 1029.
O'Connor, T. G., Marvin, R. S., Rutter, M., Olrick, J. T., & Britner, P. A. (2003). Child–parent attachment following early institutional deprivation. Development and Psychopathology, 15, 1938.
O'Connor, T. G., & Rutter, M. (2000). Attachment disorder behavior following early severe deprivation: Extension and longitudinal follow-up. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 703712.
Oosterman, M., & Schuengel, C. (2007). Autonomic reactivity of children to separation and reunion with foster parents. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 11961203.
Pears, K. C., Bruce, J., Fisher, P. A., & Kim, H. K. (2010). Indiscriminate friendliness in maltreated foster children. Child Maltreatment, 15, 6475.
Putnam, S. P., Gartstein, M. A., & Rothbart, M. K. (2006). Measurement of fine-grained aspects of toddler temperament: The early childhood behavior questionnaire. Infant Behavior & Development, 29, 386401.
Roy, P., Rutter, M., & Pickles, A. (2004). Institutional care: Associations between overactivity and lack of selectivity in social relationships. Journal of Psychology and Psychiatry, 45, 866873.
Rutter, M., Colvert, E., Kreppner, J., Beckett, C., Castle, J., Groothues, C., et al. (2007). Early adolescent outcomes for institutionally-deprived and non-deprived adoptees: I. Disinhibited attachment. Journal of Child Psychology and Psychiatry, 48, 1730.
Save the Children. (2009). Institutional care: The last resort. London: Author. Retrieved January 29, 2013, from
Smyke, A. T., Zeanah, C. H., Fox, N. A., Nelson, C. A., & Guthrie, D. (2010). Placement in foster care enhances quality of attachment among young institutionalized children. Child Development, 81, 212223.
Smyke, A. T., Zeanah, C. H., Gleason, M. M., Drury, S. S., Fox, N. A., Nelson, C. A., et al. (2012). A randomized controlled trial comparing foster care and institutional care for children with signs of reactive attachment disorder. American Journal of Psychiatry, 169, 508514.
Sroufe, L. A. (1977). Wariness of strangers and the study of infant development. Child Development, 48, 731746.
Tapp, J. (2003). Procoder for digital video [Computer software]. Nashville, TN: Vanderbilt Kennedy Center.
Tizard, B., & Hodges, J. (1978). The effect of early institutional rearing on the development of eight-year-old children. Journal of Child Psychology and Psychiatry, 19, 99118.
Tizard, B., & Rees, J. (1975). The effect of early institutional rearing on the behaviour problems and affectional relationships of four-year-old children. Journal of Child Psychology and Psychiatry, 16, 6173.
Williamson, J., & Greenberg, A. (2010). Families, not orphanages. Better Care Network Working Paper.
Zeanah, C. H., & Gleason, M. M. (2010). Reactive attachment disorder: A review for DSM-V. Retrieved from
Zeanah, C. H., Scheeringa, M. S., Boris, N. W., Heller, S. S., Smyke, A. T., & Trapani, J. (2004). Reactive attachment disorder in maltreated toddlers. Child Abuse and Neglect, 28, 877888.
Zeanah, C. H., Smyke, A. T., & Dumitrescu, A. (2002). Attachment disturbances in young children: II. Indiscriminate behavior and institutional care. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 983989.
Zeanah, C. H., Smyke, A. T., Koga, S. F., & Carlson, E. (2005). Attachment in institutionalized and community children in Romania. Child Development, 76, 10151028.
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Development and Psychopathology
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